Basic Information
| Provider Information | |||||||||
| NPI: | 1922398825 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | KAISER PERMANANTE | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 1225 15TH AVENUE | ||||||||
| Address2: | |||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 96816 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8084320000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1225 15TH AVE | ||||||||
| Address2: | |||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968163840 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8084320000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2011 | ||||||||
| LastUpdateDate: | 04/12/2011 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | HOE | ||||||||
| AuthorizedOfficialFirstName: | SHIRLEY | ||||||||
| AuthorizedOfficialMiddleName: | MASAKO | ||||||||
| AuthorizedOfficialTitleorPosition: | COTA | ||||||||
| AuthorizedOfficialTelephone: | 8084320000 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | ASSOCIATE DEGREE | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | Y | Hospitals | General Acute Care Hospital |
No ID Information.